Dr. Adrienne Owens is a local Chiropractic Doctor in the Federal Way area. The following are the notes from a recent lecture outlining Carpal Tunnel Syndrome and important things to know for diagnosis and treatment options. If you would like more information, please go to https://owenschiropracticps.com/ and set up an appointment with Dr. Owens. Tell them Maria Riggins sent you!

Carpal Tunnel Lecture Overview:

  • What is Carpal Tunnel?
  • Other compressive neuropathies that can be confused with Carpal tunnel syndrome.
  • What Causes Carpal Tunnel
  • Signs and Symptoms
  • How to Treat Carpal Tunnel Syndrome

A. What is Carpal Tunnel?

    1. Compression of the median nerve as it passes through the carpal canal with the cutaneous branch innervating the thumb, index finger and middle finger resulting in numbness, tingling, and possible weakness in the 1st three fingers.
    2. It is the most common compressive neuropathy in the work place, 1% of all workman’s comp claims.
    3. On the rise as global computer usage increases

B. Other Compressive Neuropathies that can be confused with Carpal Tunnel Syndrome.

    1. Compression of the median nerve at the pronator teres and flexor carpi muscles in the forearm as associated trigger points.
    2. Compression of the median nerve at the brachial plexus of the shoulder
    3. Cervical Radiculopathy from degeneration in the neck
    4. Cervical Radiculopathy from disc herniation
    5. Subluxation of the lunate bone of the wrist
    6. Thoracic Outlet Syndrome

C. What Causes Carpal Tunnel?

  • Multi- factoral causes
    1. Mechanical constriction and local swelling such as osteoarthritis, RA, ganglion cyst, finger flexor tendonitis or subluxation of the lunate bone
    2. Overuse syndromes such as repetitive finger flexion, extension and ulnar deviation such as typing. Jobs that commonly get carpal tunnel are cashiers, mechanics, typists, painters, massage therapist. Jobs with vibration such as construction workers using a jack hammer, seamstress, truck drivers. Athletes such as cyclists, gymnasts, rock climbers
    3. Systemic changes that have resulted from conditions such as obesity, pregnancy, diabetes, and diseases that cause water retention and edema.
    4. Traumas such as fractures of the carpal bones, FOOSH injuries

D. Signs and Symptoms

    1. Numbness and tingling in the first three fingers of the hand
    2. Decreased sensation and decreased discrimination between sharp and dull
    3. Decreased strength of pinch
    4. Positive orthopedic tests such as Phalen’s Test, Reverse Phalen’s Test, and the specific test is compression over the carpal tunnel with performance of Phalen’s test
    5. Advanced imaging for diagnosis – CT, MRI and nerve conduction test

E. How to Treat Carpal Tunnel Syndrome

  1. Avoid repetitive finger flexion and extension, prolonged vibratory tasks, and repetitive, prolonged gripping
  2. Wearing wrist supports to keep the wrist in neutral at night
  3. Chiropractic manipulation of the cervical spine, cervical-thoracic junction, shoulder, elbow and wrist
  4. Soft Tissue Therapy
    • Stretching of the elbow flexors, wrist flexors
    • Graston Technique or A-Stim (tool assisted soft tissue release)
    • Deep tissue massage of the soft tissues of the neck and arm
  5. Heat and Ice massage
  6. Natural anti-inflammatories; Bromelain, turmeric

*If conservative therapy does not work, referral may be warranted.